CMS Unveils New ICD-9 Codes:
More Precision for Converted Surgeries, Muscle Weakness
Published on Fri Aug 01, 2003
New ICD-9 codes for 2004 will allow you to report several conditions or circumstances, including muscle weakness and converted surgeries, and in one case will simplify coding by eliminating a fifth digit from an already-existing diagnosis.
There really are no revolutionary changes to ICD-9 this year, but there are a number of interesting new codes, says Marcella Bucknam, CPC, CCS-P, CPC-H, CCA, HIM program coordinator at Clarkson College in Omaha, Neb.
New signs and symptoms codes will be helpful in describing some of those situations that are hard to code when you dont have a definitive diagnosis, Bucknam says. These include:
780.94 Early satiety
781.94 Facial weakness
785.52 Septic shock
788.63 Urgency of urination
790.21 Impaired fasting glucose
790.22 Impaired glucose tolerance test (oral)
790.29 Other abnormal glucose
799.81 Decreased libido
799.89 Other ill-defined conditions.
Other additions include new V codes for long-term drug use. These are going to be of interest to the vascular surgeons and possibly the surgical oncologists who have their patients on steroid or antiplatelet therapy that has to be monitored. Other surgeons will be interested in these codes because this long-term drug use adds to the complexity of surgical procedures and adds to healing times, post-op bleeding, etc., Bucknam says. The codes include:
V58.63 Long-term (current) use of antiplatelet/antithrombotic
V58.64 Long-term (current) use of nonsteroidalanti-inflammatories
V58.65 Long-term (current) use of steroids.
Additionally, V64.4 now includes a fifth digit to better identify the various types of scope conversion procedures, as follows:
V64.41 Laparoscopic surgical procedure converted to open procedure
V64.42 Thoracoscopic surgical procedure converted to open procedure
V64.43 Arthroscopic surgical procedure converted to open procedure.
Now You Can Report Muscle Weakness
A new code will finally allow physicians to specify a diagnosis of muscle weakness. Now, if a patient presents to your practice complaining of muscle weakness, your only choice is to report the code for unspecified disorder, 728.9 (Unspecified disorder of muscle, ligament, and fascia). For 2004, however, you may assign the new code 728.87 (Muscle weakness), which more accurately describes the patients condition.
Most physicians are unsure of what unspecified codes such as 728.9 include, says Mary J. Brown, CPC, CMA, specialist at OrthoWest PC, a seven-physician practice in Omaha, Neb. More descriptive ICD-9 codes like 728.87 help paint a picture for your insurer, and that can save time by staving off unnecessary denials and appeals.
Note: CMS has not deleted 728.9. You may still assign this code for other muscle, ligament and fascia conditions that the more specific ICD-9 codes do not describe.
Go Ahead, Abbreviate the Difficulty-Walking Code
If you report 719.7x (Difficulty in walking) today without adding a fifth digit to describe the site, your carrier will most likely deny the claim for a truncated [...]
